My uncle is 40 years old and recently went through an open heart CABG operation. We had assumed that his public health insurance policy would suffice to cover the entire cost. To our dismay, at the last minute we were informed that it was only the hospitalisation cost that would covered and that too under some conditions. Is there any plan that covers all the costs involved in such a complex procedure?

Jigyasa

Offer and acceptance are the essential elements of a legally binding contract. The terms that will bind the insured and the insurer are stated in the policy document.

Health insurance policy generally covers hospitalisation expenses for the treatment of illness or injury provided hospitalisation is for more than 24 hours.

Pre-existing diseases are covered only after continuous and claim-free renewals for a specified period in the policy. Sometimes co-pay or sub-limit clause is applicable in the policy for different treatment and procedures.

Top-up Plans

I have a health cover of Rs3 lakh from Star Health. I want to take a top-up policy of Rs5 lakh. Which one do you recommend?

Kavindra Salunke

You can consider Star Health Super Surplus or Bajaj Allianz Extra Care. These are top-up health insurance plans. There is compulsory deductable for each and every hospitalisation, this means you can claim loss under these policies in excess of the specified limit.

My father is deaf and I just learnt that Max Bupa as well as other private health insurers don't cover such children for deafness as it is genetic. As a mother, I would like to know of a health insurance plan that would provide medical relief to my child to cover doctor's check-up etc. Also, is there a critical illness plan which can cover this deficiency if ever my child was to face it?

Kokil

Health insurance policies generally cover hospitalisation expenses for the treatment of illness or injury. Expenses which are purely diagnostic in nature with no positive existence of any disease are not covered under health insurance policy.